Transplant Position News

Yesterday I received an email from my transplant coordinator updating me on my place on the Transplant Recipient list. The following is the email I received from my coordinator:

..."Scott’s place on the list:  Disclaimer …. this is not a guaranteed, set in stone number. It changes daily and only takes IMC’s active patients into consideration, not the University of Utah who shares the list in Utah. With that being said – I told you #11 when you were here based on one report from early June of this year. Per the UNOS list, he is 14. {If you} subtract the high PRA patients from that list, Scott is 9.

You requested Scott’s KDPI score.  KDPI = Kidney Donor Profile Index – this number is assigned to the donor.

Scott is a recipient, so we look at his EPTS score.  EPTS = Estimated Post Transplant Survival score – this number is assigned to the recipient.

Scott’s EPTS = 34%.  This means Scott will receive offers from donors with a KDPI between 21-34%, preferably. But, he will also receive offers from donors with KDPI scores up to 85%.

Great News! I am about where I thought I'd be in my previous blog. With the Holidays approaching, my standing will only get higher over a relatively short period of time.

So, you are probably asking, 'What are those numbers, and what do they mean?'

Here's a brief explanation for each one:

PRA  (from CIDPUSA.com)

                                           "What's IS PRA?

Panel Reactive Antibody (PRA) – Measures  Immune system activity. Higher PRA means more antibodies are being made.  The less activity here, the better chance the body will not reject the transplanted kidney. Immune system activity test. The calmer your immune system is, the easier it will be to get a kidney.  A higher immune system activity means your body fights foreign objects (like a transplanted kidney) more vigorously. Blood transfusions, pregnancy, previous transplant(s) or a current infection can cause your immune system to be more aggressive.

PRA is a blood test that measures the level of antibodies in your blood. The more antibodies that are seen, the more difficult it will be to find a compatible donor. A normal person’s PRA can be anywhere from 0% to 99%. The PRA should be low; the lower it is the better your chances of having a transplant accepted by your body. If the PRA is [high] in the 90’s, you are a poor candidate for a transplant as your antibodies will reject the new kidney.

You can develop a high PRA from blood transfusions, an earlier transplant or from being pregnant."

KDPI (from US Dept of Health and Human Services)

"The Kidney Donor Risk Index (KDRI) combines a variety of donor factors to summarize the risk of graft failure after kidney transplant into a single number. The KDRI expresses the relative risk of kidney graft failure for a given donor compared to the median kidney donor from last year; values exceeding 1 have higher expected risk than the median donor, and vice versa.
The KDPI is a remapping of the KDRI onto a cumulative percentage scale, such that a donor with a KDPI of 80% has higher expected risk of graft failure than 80% of all kidney donors recovered last year and can be used to compute KDPI and KDRI for a hypothetical or actual donor. The calculations and assumptions mirror those used for computing KDPI and KDRI in DonorNet^®."

EPTS Score (from  US Dept of Health and Human Services)

"An Estimated Post Transplant Survival (EPTS) score is assigned to all adult candidates on the kidney waiting list and is based on four factors:

1. Candidate time on dialysis
2. Current diagnosis of diabetes
3. Prior solid organ transplants
4. Candidate age

A candidate's EPTS score can range from 0% to 100%. The candidates with EPTS scores of 20% or less will receive offers for kidneys from donors with KDPI scores of 20% or less before other candidates at the local, regional, and national levels of distribution. The EPTS score is not used in allocation of kidneys from donors with KDPI scores greater than 20%.

To calculate an EPTS score for a hypothetical or actual candidate, please enter data for each required variable below.
-DOB
-Age

-Has the candidate had regularly administered dialysis for ESRD? Yes No
-Current Diabetes Staus (Y/N, Type)
-Number of previous Solid Organ Transplants

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Now, after all those explanations, you might still have questions. That's OK, because I am STILL getting all of this down myself.
Briefly...

My PRA (antibody score) is 0. That is THE best score anyone can have. A zero "0" PRA means that you have no antibodies, and are able to take any compatible organ.

At 34, my EPTS score is well below average for a man of my age. Most men at 53 would hav a score in the high 50's to low 60's. I attribute the low score to a lifetime of exercise and 100% compliance to everything expected of me by my physicians, dialysis team and transplant team.
In short, because of my very low EPTS score, I will be offered a low KDPI organ, which will give me the greatest chance that my transplant will last me the rest of my life.

(Remember, the KDPI score is given to the donor, which is then matched with a similarly scored EPTS patient.)

Got it?

Yeah. Me neither...but I'm getting there! :o)

If you have questions about any of this, please ask me. If I don't know the answer, I'll go find it. Doing so only helps me to solidify my knowledge, so I really don't mind searching for the information.

Anyhow, after all of that, I am at #9 on the transplant list! That is AWESOME news!

Good Health to All!

ScottW